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A Surprising Risk Factor Linked To Rising Liver Disease In Children, New Research

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A new study published today in JAMA Network Open reveals a lesser-known risk factor for the growing incidence of potentially cancer-causing liver disease in children and leading to severe chronic liver disease and liver cancer in adulthood.

Researchers from Mount Sinai University have discovered a link between prenatal exposure to various endocrine disruptors and the rising prevalence of potentially cancerous liver disease in kids.

It is the first in-depth investigation into the link between prenatal exposure to certain chemicals and chemical mixtures and non-alcoholic fatty liver disease. Researchers employed cytokeratin-18 as a unique illness marker for kids.

The findings, which were published in JAMA Network Open in July, highlight the significance of comprehending prenatal exposure to environmental chemicals as a risk factor for non-alcoholic fatty liver disease, a problem that is rapidly becoming more prevalent in children and can result in serious chronic liver disease and liver cancer in adults.

According to first author Vishal Midya, PhD, the findings of the study “can inform more efficient early-life prevention and intervention strategies to address the current non-alcoholic fatty liver disease epidemic.”

“We are all daily exposed to these chemicals through the food we eat, the water we drink, and the use of consumer products,” said Senior author Damaskini Valvi, adding “This is a serious public health problem.” 

The study results “show that early life exposure to many endocrine-disrupting chemicals is a risk factor for pediatric non-alcoholic fatty liver disease, and draw attention for additional investigation needed to elucidate how environmental chemical exposures may interact with genetic and lifestyle factors in the pathogenesis of liver disease.”

Non-alcoholic fatty liver disease is one of the most prevalent liver disorders in the world and is increasingly identified in children, affecting 6 to 10 percent of the general pediatric population and 34 percent of obese children.

A broad category of environmental contaminants known as “endocrine-disrupting chemicals” includes numerous pesticides, plastics, flame retardants, and hazardous metals. Examples include polybrominated diphenyl ethers (PBDEs), which are used as flame retardants in furniture and baby items, and perfluoroalkyl substances (PFAS), also known as “forever chemicals,” which are applied in nonstick cookware and food packaging. Endocrine-disrupting toxins alter the human body by messing with hormones and metabolism.

The possible effects of prenatal combination exposures to these chemicals have not yet been researched in humans, despite the fact that several experimental investigations have demonstrated that exposures to these chemicals can cause liver damage and non-alcoholic fatty liver disease.

In this investigation, 45 substances were found in the blood or urine of 1,108 pregnant women between 2003 and 2010. Endocrine-disrupting substances such as PFAS, organochlorine and organophosphate pesticides, plasticizers (phenols, phthalates), PBDEs, and parabens were among the compounds found.

When the children were between the ages of 6 and 11, researchers measured the levels of enzymes and cytokeratin-18 in the children’s blood to determine their risk for liver disease. They discovered elevated levels of those biomarkers in kids whose mothers had been exposed to more environmental chemicals during pregnancy.

“By understanding the environmental factors that accelerate fatty liver disease,” according to Robert Wright, MD, MPH, Ethel H. Wise Chair of the Department of Environmental Medicine and Public Health and Co-Director of the Institute for Exposomic Research at Icahn Mount Sinai, “we can reduce people’s risk by giving them actionable information to make informed choices that reduce the risk or impact of the disease.”

“Exposomics is the wave of the future because once you’ve sequenced the human genome, which has been done, there isn’t much more you can do in genomics alone,” the expert said.

“The missing piece of the puzzle for us to understand different diseases is to measure their environmental causes, and exposomics is a way to accelerate our knowledge of how the environment is affecting our health.”

Human Early-Life Exposome is a collaborative network of six ongoing population-based prospective birth cohort studies from six European countries: France, Greece, Lithuania, Norway, Spain, and the United Kingdom.

This study’s shortcomings include the inability to conduct a liver biopsy, the gold standard for establishing a causal association with non-alcoholic fatty liver disease, due to the risk and ethical constraints associated with the children’s age.

Image Credit: Getty

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